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A recent report found that Southeast Asia was home to more than 72 million adults with diabetes in 2013, a number that is expected to exceed 123 million in 2035. Over 90% of them have type II diabetes. Cambodia is a case in point. King et al. studied 2246 randomly selected adults aged 25 years and older in two Cambodian communities. Prevalence of diabetes was 5% in the rural community and 11% in the semi-urban community. Fully one quarter of all adults in the semi-urban community had some degree of glucose intolerance. Type II diabetes is multifactorially determined, and in Cambodia may be linked to lifestyle changes associated with urbanization and industrialization, high rates of mental illness, historical exposure to starvation and current malnutrition. There is an urgent need for diabetes prevention programs in Cambodia. Trials have shown that type II diabetes can be delayed or prevented with structured lifestyle modification. Diet and exercise interventions have been shown to be effective in China and India. These findings illustrate the benefits of lifestyle on diabetes risk among younger individuals with lower body mass index than Caucasian populations typically studied in the US and Europe.